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The Real Value of In-Home Care Work in the United States

By Caroline Dobuzinskis

Baby Boomers, estimated at nearly 80 million in the United States, began turning 65 in 2011.By 2020, the population of older adults is expected to grow to 55 million from 40.4 million in 2010. As more women enter the labor force and fewer are able to care for older family members, providing in-home care to the growing aging population, as well as the disabled and chronically ill, is becoming more critical to a robust U.S. economy.

A new briefing paper by IWPR, “Women and the Care Crisis: Valuing In-Home Care in Policy and Practice,” outlines these challenges but emphasizes that, despite the growing demand, in-home care work jobs continue to be undervalued and underpaid.

While often working long hours to care for others, many in-home care workers cannot afford to take care of their own needs. According to IWPR’s analysis, the median weekly earnings for all female in-home care workers are $308, compared with $560 for all female workers in the U.S. workforce. In-home care workers are also excluded from coverage by the Fair Labor Standards Act, the federal law that helps ensure basic standards of living for U.S. workers by requiring employers to pay minimum wages and provide overtime compensation.

The general lack of value placed on paid care work is due to a number of complex factors. Research suggests that what is seen as traditionally women’s labor, at all skill levels, reaps lower economic rewards. The simple fact that the majority of paid care work is performed by women could contribute to its lower average wages. Care work also blurs the lines between formal and informal labor, which can result in the workers being perceived as part of the family and make it more difficult for them to set boundaries that define the requirements and terms of their jobs.

Many in-home care workers are immigrants who may lack pathways to legal status, leaving them vulnerable to low levels of pay and to abuses from employers. According to IWPR research analysis, 90 percent of home health care aides in the United States are women, 56 percent are women of color, and 28 percent are foreign-born with the vast majority (60 percent) migrating from Latin America and the Caribbean. Despite the fact that these immigrant workers are filling an essential labor gap, many remain undocumented and without clear access to citizenship or visa status. Many domestic worker and immigrant groups are waiting to see if Congress will address this issue.

Among the recommendations in IWPR’s report, Increasing Pathways to Legal Status for Immigrant in-Home Care Workers (published February 2013), is an increase in the number and types of immigration visas available to immigrant care workers to help fill the labor shortage in the U.S. industry. The most recent immigration deal being crafted the “Gang of Eight,” a bipartisan group of U.S. senators tasked with finding immigration reform solutions, includes an option to provide temporary work visas to undocumented immigrants performing essential, low-skilled labor.

IWPR’s briefing paper, “Women and the Care Crisis: Valuing In-Home Care in Policy and Practice,” proposes several changes that would improve circumstances for all care workers and recipients, as well as the industry as whole, including:

1. Encouraging public dialogue about the growing need for care work and the skills and contributions of those who provide in-home care

2. Improving estimates of the value of unpaid care work and making the public more aware of this work’s critical importance to the nation’s economy.

3. Implementing public policies that affirm the value of care work and those who provide it.

4. Creating more quality in-home care work jobs that will improve the employment prospects of the female workforce, help to reduce inequality, and strengthen the U.S. economy overall.

Many groups and organizations, such as Caring Across Generations, support improved workers rights for care workers nationwide. New York State passed a law entitling domestic workers to, among other provisions, a minimum wage, pay for overtime hours, one day of rest for every seven days, and at least three paid leave days per year after one year of work for the same employer. Further policies are still needed that affirm the value of care work in order to reduce the inequality in wages for these workers and strengthen the U.S. economy overall.

Caroline Dobuzinskis is the Communications Manager with the Institute for Women’s Policy Research.